Izimpendulo Zemibuzo Ejwayelekile Ngokuba Nokuhlangana Okuhlangene
Ukwelashwa kubhekwa njengendlela "yokukhethwa kokugcina yokukhethwa kokukhetha" ngamalungu awonakele kakhulu yi-arthritis . Ngenkathi ukuhlinzwa ngokuhlanganyela esikhundleni sekuye kwanda inqubo ejwayelekile, ikakhulukazi amajoyini athile, akuzona zonke izixhumanisi ezithintekayo ezikhethwa ukushintshwa. I-Arthrodesis, eyaziwa nangokuthi i-fusion ehlangene, ingase ifaneleke kakhulu ama-ankle, izigqoko, izithupha, izinzwane, iminwe, kanye ne-vertebrae ephezulu entanyeni.
Amaphethelo amathambo amabili ahlanganiswa ndawonye e-arthrodesis ene-screw fixation kanye ne-bone possible grafting, kuye ngokuthi isimo sethambo.
Izinkomba
Kunezizathu eziningana ezihlukahlukene ukuhlanganiswa okuhlangene kunganconywa. Lokhu kufaka:
- Ukungazinzi okuhlangene
- Ukulimala okuhlangene okubangelwa ukulimala noma izifo
- Ubuhlungu ngokuhamba kombuthano
Umgomo we-arthrodesis ukuphumula ubuhlungu futhi wabuye waqina nokuqina. Amathambo ahambisana nesikhundla esisebenza kakhulu kodwa alahlekelwe ukunyakaza kwawo kwemvelo. Ake sibheke eminye imibuzo evamile abantu abanayo mayelana nokuhlinzwa okuhlanganyelwe kwe-fusion.
Isikhathi
I-fusion ivame ukwenza njengendlela yokugcina emva kwemithi nezinye izinqubo zokwelapha ubuhlungu ziveza imiphumela enganelisi. Ngamanye amazwi, i-arthrodesis ivame ukucatshangwa kuphela emva kokwelashwa okunamandla kokuthola isifo samathambo ehlulekile. Ubuhlungu obunzima obuveza ukuthi ukuhlinzeka nge-fusion kuyabonakala lapho i- bone itholakala emathanjeni ngemuva kwe-cartilage iye yaphela kakhulu.
Kule nkinga kulesi sifo, ngokuvamile kuvame ubufakazi obucacile bokubhujiswa okuhlangene kubonakala kwi-x-ray.
Ukuphumelela
Ngokuyinhloko, i-fusion izosikhulula iningi lobuhlungu umuntu abhekene nalo ngenxa ye-arthritis enamandla ngokuhlanganyela. Kukhona, kodwa, izivalo ezimbalwa kule mpendulo. Umphumela omuhle utholakala uma kungekho izinkinga futhi uma udokotela ohlinzayo ekwazi ukuphumelela izinga eliphezulu, ngokufanele enze inqubo kaningi.
Ukwehluleka ukubeka isikhumba "esimweni esihle" kungaholela emiphumeleni emtholampilo empofu.
Ngokuyinhloko konke ukunyakaza okuhlangene kuvame ukuhlatshwa lapho kuhlanganiswa ukuhlanganiswa okuhlangene, njengoba ukuhlanganiswa kufakwa endaweni ehleliwe. Nge-fusion yama-ankle, uma i-ankle ixoshwa endaweni ehle, ukunyuka okungekho emthethweni ku-motion kungalindelwa emajoyini emaphakathi. Izicathulo ezisezingeni eliphansi zivame ukunconywa ukukhokhela ukulahlekelwa kwesimiso uma kunzima.
Ukubuyisela
Ukulandela i- fusion ye-ankle , kuzodingeka ube okungezona isisindo isikhathi semasonto ayisithupha kuya kwangu-12, futhi lokhu kungahlukahluka kuye ngezici eziningana. Ukulandela ukuhlanganiswa kwe-ankle yakho, udokotela wakho uzolandela i-x-rays, futhi ukukhiqiza isisindo okungavinjelwe kungaqala kuphela emva kokushaya kwesitembu kubonakala ku-ray ray kusayithi lokuhlanganiswa.
Isikhathi sokuchitha isikhathi esiphezulu kuze kube yilapho konke okususwa kukhishwa kuphakathi kwezinyanga ezingu-4 no-7. Izikhonkwane azisuswanga uma isetshenziselwa ukusebenzisana ngaphakathi. Kukhona namasu okulungisa angaphandle, kanye ne-arthrodesis ye-arthroscopic.
Kubantu abaphethe i-ankle fusion ehambisana kahle, ukuhamba okuhambayo esikhwameni esifanele (kusobala ukuthi izithende eziphezulu ziphuma!) Cishe zivamile. Ukubheka kwakho kungase kubonakale sengathi kuyingozi, kodwa lokhu kuvame ukucashile, futhi kubonakala sengathi kuyinto evamile.
Ukugijima noma ukuhamba endaweni engalingani kwenziwa kanzima.
Izinhlobo Zabafisi
I-Ankle: Mhlawumbe uke wabona noma uzwe kabanzi mayelana nokuxolisa ama-ankle, kodwa ukuxolisa kwamanye amalunga kungaphumelela kakhulu ekunciphiseni ubuhlungu ngenxa ye-arthritis noma ukulimala. Ukuhlanganiswa kweminwe noma izinzwane akubhekwa njengokusebenza okunzima, kodwa isikhathi sokuvuselela siyisikhathi eside futhi sinzima. Njengezinsikazi noma noma yikuphi ukuhlanganiswa okuhlangene, ukunyakaza kuhlatshelwe ukuphumula ubuhlungu nokuzinza. Enye imisebenzi ingabuyiselwa ngokusimama okwandayo.
Isiqalo: Uma ucabangela i-fusion yesandla, futhi uzwile ngezingxube zezinyosi, ungase uzibuze ukuthi ukunyakaza kuzokwenzeka kangakanani.
Uzokwazi yini ukubhala nokuthayipha? Impendulo izoxhomeka ikakhulukazi kumuntu othile kanye nesimo seminwe ngaphambi kokuhlinzwa, njengoba ukunyakaza okudingekayo ukubhalwa nokuthayipha kuza ngokuyinhloko kusuka eminwe, hhayi isibindi.
Izinkinga
Njengazo zonke izinqubo zokuhlinza, ukutheleleka kuyinkimbinkimbi engenzeka, kanye nokudonswa kwesilonda (ukuhlukaniswa okuvulekile emgqeni wokungena). Ukuhlanganiswa okwehlulekile nakho kungenzeka, lapho ithemba liphela khona alifani ngokuphelele naphezu kokulungiswa. Isimo esaziwa ngokuthi i- osteopenia singase senze ukwenziwa komsebenzi.
Ezinye izinkinga ezikhona kungenzeka zibandakanya ubuhlungu obuqhubekayo endaweni yokuxuba, ukulimala kwamantombazane ngesikhathi sokuhlinzwa, ne-hardware ephukile okumelwe ishintshwe. Izinkinga ze-ankle fusion operation ziphakeme kubantu ababhema, nokuyeka ukubhema kufanele kucatshangelwe kakhulu ngaphambi kokuhlinzwa.
I-Ankle Fusion vs. Ukushintshwa Kwe-Ankle
Kungenxa yokuthi kokubili ukukhishwa kwe-ankle kanye ne- ankle kungabangela ukukhululeka ebuhlungu futhi kubuyisele ukuzinza, futhi ukunyakaza okungaphezulu kugcinwa nge-substitution yama-ankle, kungani i-fusion yama-fusion ingaba inqubo engcono? Ukukhathazeka okuyinhloko ngokuhlinzwa okwenziwa nge-ankle ukulinganiselwa kwezinga lokuhluleka kwama-prostheses esikhundleni sesikhumba. Ngokuphambene nalokho, kubonakala sengathi kunezinga elingamaphesenti angu-85 lokuphumelela nge-ankle fusion kubantu abane- arthritis ye-rheumatoid . Izinga lokuphindaphinda libuye liphansi ne-fusion yama-ankle uma kuqhathaniswa nokuhlinzwa kwesigqoko se-ankle.
Okubalulekile
I-fusion ehlangene ingaletha impumuzo ebuhlungu obuqhubekayo bokugula i-arthritis futhi iqinise ukuhlanganiswa, kodwa lokhu kukhulumisana ubuhlungu kuhanjiswa ukulahlekelwa ukuhamba. Lokho kusho ukuthi i-arthrodesis ayidlalwa njalo kuze kube yilapho umonakalo omkhulu kakhulu ekuhlanganyeleni kwenzeka futhi imithi kanye nezinye izinyathelo zokuphumula zobuhlungu asisasebenzi. Okunye okunye ukukhishwa kwe-ankle ukuguqulwa kwe-ankle, kodwa nge-arthritis enamandla, ithuba lokuphumelela kokuhlinzwa livame ukuphakama nge-fusion ehlangene.
Kubalulekile ukuxoxa ngokucophelela zonke izinketho zakho kanye nezingozi kanye nezinzuzo zomuntu ngamunye nomhlinzeki wakho wezinambuzane nodokotela we-rheumatologist. Wonke umuntu uhlukile, futhi okusebenzelani okungcono komunye umuntu kungase kungabi yisinqumo esihle kuwe. Buza imibuzo eminingi. Ungase ufise ukubuza ohlinzayo wakho wamazinyo uma ungakhuluma nomuntu oye wadlula ngenqubo. Ngenxa yemithetho yemfihlo, udokotela wakho uzodinga ukuthola imvume evela kwesinye isiguli ukuhlela lokhu, kodwa abantu abaningi abaye balwa nezinselele ezifanayo namuhla banomdlandla wokudlula kulokho okubasizile ekuhambeni kwabo nge-arthritis.
> Imithombo:
> Kim, J., noS. Patel. Ingabe Kufaneleka Ukucwasana Neziguli Ezibhemayo? Ukuhlaziywa Kwezincwadi Ezihleliwe Ngemihlahlandlela Yokusetshenziswa Kogwayi Ngamaqhawe Nokuhlinzwa Kwe-Ankle. I-Journal of Foot and Ankle Surgery . 2017. 56 (3): 594-599.
> Morash, J., Walton, D., noMnu Glazebrook. I-Ankle Arthrodesis I-Ankle Yonke I-Ankle I-Arthroplasty. Imitholampilo yezinyawo kanye ne-Ankle . 2017. 22 (2): 251-266.
> Wheeless 'Umbhalo Wezincwadi Ze-Orthopedics. I-Ankle Arthrodesis.